Changes in Spectrum of Respiratory Pathogen Infections and Disease Severity Among Children in Hohhot: Impact of COVID-19 Prevention Measures (preprint)

Background Acute respiratory infections (ARIs) are caused by various pathogens, and the outbreak of the novel coronavirus has led to changes in the patterns of respiratory pathogen infections. Through long-term study of respiratory tract infection data in children from Hohhot, significant differences in the spectrum of respiratory pathogen infections, disease severity, and seasonal patterns have been discovered between 2022 and 2023.Methods Throat swabs were collected from 605 children with ARIs at the First Hospital of Hohhot, and pathogen detection was performed using microarray technology. Blood biomarkers, symptoms, and clinical diagnoses were evaluated.Results The study found that 56.03% of the patients were male, with an average age of 3.45 years. Pathogen dynamics revealed that SARS-CoV-2 was the most prevalent infection, accounting for 262 cases. It persisted from October 2022 to January 2023 and then disappeared. Influenza A virus (IAV) cases peaked in March 2023. Respiratory syncytial virus (RSV), Influenza B virus (IBV), Parainfluenza virus (PIV), Mycoplasma pneumoniae (M. pneumoniae), Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Group A streptococcus (GAS) were not detected after December 2022. The proportion of mixed infections was 41.94% among SARS-CoV-2 patients, while other pathogens had mixed infection rates exceeding 57.14%. Before December 2022, the mean value of white blood cell (WBC) count for Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), Epstein-Barr virus (EBV), and Cytomegalovirus (CMV) was 8.83*10^9/L, C-reactive protein (CRP) was 18.36 mg/L, and procalcitonin (PCT) was 1.11 ng /ml. After December 2022, these values decreased to 5.5*10^9/L, 6.33 mg/L, and 0.24 ng /ml, respectively. Similarly, the proportion of patients with cough, difficulty breathing, and running nose, as well as the diagnosis of lower respiratory tract infections, decreased in December 2022. However, the situation was different for SARS-CoV-2 infections.Conclusions Strict SARS-CoV-2 policies reduced the infection risk for S. pneumoniae, H. influenzae, EBV, and other pathogens before November 2022. However, patient symptoms worsened compared to after November 2022, possibly due to an excessive focus on SARS-CoV-2, neglecting other diseases, and reduced population immunity to respiratory infections.

Alpha-1 antitrypsin protects against phosgene-induced acute lung injury by activating the ID1-dependent anti-inflammatory response (preprint)

Phosgene, a highly dangerous chemical warfare agent, is widely used as an industrial chemical. Phosgene inhalation causes acute lung injury (ALI), which may further progress into pulmonary edema. Currently, there is no known antidote for phosgene poisoning. Alpha-1 antitrypsin (α1-AT) is a protease inhibitor that has been used to treat emphysema patients, who are deficient in α1-AT, for decades. Recent studies have shown that α1-AT has both anti-inflammatory and anti-SARS-CoV-2 effects. In this study, we aimed to investigate the role of α1-AT in phosgene-induced ALI. We observed a time-dependent increase in α1-AT expression and secretion in the lungs of rats exposed to phosgene. Interestingly, α1-AT was derived from neutrophils, but not from macrophages or alveolar type II cells, and α1-AT knockdown aggravated phosgene- and lipopolysaccharide (LPS)-induced inflammation and cell death in human bronchial epithelial cells (BEAS-2B). Conversely, α1-AT administration suppressed the inflammatory response and prevented death in LPS- and phosgene-exposed BEAS-2B cells. Furthermore, α1-AT treatment increased the expression of the inhibitor of DNA binding (ID1) gene, which suppressed NF-κB pathway activation, reduced inflammation, and inhibited cell death. These data demonstrate that neutrophil-derived α1-AT protects against phosgene-induced ALI by activating the ID1-dependent anti-inflammatory response. This study may provide novel strategies for the treatment of patients with phosgene-induced ALI.

Short-term safety and immunogenicity of inactivated and peptide-based SARS-CoV-2 vaccines in patients with endocrine-related cancer

Background The aim of this study was to explore the short-term safety and immunogenicity of inactivated and peptide-based SARS-CoV-2 vaccines in patients with endocrine-related cancer (ER). Methods Eighty-eight patients with ER cancer and 82 healthy controls who had completed a full course of inactivated or peptide-based SARS-CoV-2 vaccines were recruited. Adverse events (AEs) were recorded. Responses to receptor-binding domain IgG antibody (anti-RBD-IgG), neutralizing antibodies (NAbs) and RBD+ memory B cells (MBCs) were evaluated. Results Approximately 26.14% (23/88) of patients with ER cancer reported AEs within 7 days, which was comparable to that reported by healthy controls (24.39%, 20/82). Both the overall seroprevalence of anti-RBD-IgG and NAbs was obviously lower in the cancer group (70.45% vs. 86.59%, P < 0.05;69.32% vs. 82.93%, P < 0.05, respectively). Anti-RBD-IgG and NAbs titers exhibited similar results, and dropped gradually over time. Patients with ongoing treatment had an attenuated immune response, especially in patients receiving active chemotherapy. The frequency of overall RBD+ MBCs was similar between the two groups, but the percentage of active MBCs was remarkably reduced in patients with ER cancer. Unlike antibody titers, MBCs responses were relatively constant over time. Conclusion Inactivated and peptide-based COVID-19 vaccines were well tolerated, but with lower immunogenicity for ER cancer patients. More intensive antibody monitoring and timely booster immunization is recommended for patients with ER cancer presenting disordered subpopulations of RBD+ MBCs.

Epidemiological and clinical characteristics of 10 children with coronavirus disease (COVID-19) in Jinan City

Objective: To analysis the epidemiological and clinical characteristics of 10 children with coronavirus disease(COVID-19) in Jinan City.

Investigation and analysis of a cluster of COVID-19 associated with exposure to a shopping mall in Jinan City

Objective: To analyze a cluster outbreak of COVID-19 associated with exposure to a shopping mall in Jinan City, investigate the possible transmission chain, and provide reference for further prevention and control.

Cost-effectiveness analysis of BNT162b2 COVID-19 booster vaccination in the United States

Objectives: To evaluate the cost-effectiveness of a booster strategy in the US. Methods: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of Pfizer-BioNTech BNT162b2 (administered 6 months after 2nd dose) among older adults, from a healthcare system perspective. Results: Compared with 2-doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million in vaccination cost, but save $6.7 million in direct medical cost and gain 3.7 QALYs in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that a booster strategy has a high chance (67%) of being cost-effective. Notably, the cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. If vaccine efficacies reduce by 10%, 30%, and 50%, this threshold will increase to 9.7/100,000, 13.9/100,000, and 21.9/100,000 person-day, respectively. Conclusion: Offering BNT162b2 booster to older adults aged ≥65 years in the US is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-COV-2 transmission.

Research and Prospect Analysis of Sports Consumption Willingness Based on Public Health Emergencies

In 2020, the sudden outbreak of coronavirus disease 2019 (COVID-19) has had a great impact on the health and life of people all over the world, and the sports industry is facing unprecedented challenges due to its participation and strong clustering. Based on the questionnaire survey, literature analysis, and other research methods, this study introduces the stimulus-organism-response (SOR) theory, takes the sports and consumption of Kunshan citizens as the research subject, and draws lessons from the structural equation model (SEM) to build a theoretical model of sports consumption characteristics and future consumption willingness. The results of empirical analysis show that physical sports consumption has been greatly affected by the epidemic, but because people realize the importance of sports, the willingness of residents to consume sports increases, and the venue and other factors affect the ornamental and participating sports consumption willingness decreases. At the same time, the restrictive factors, such as lower educational background, increased age, and lack of time, make the sports consumption willingness of this characteristic group significantly lower than that of other citizens. This study puts forward some suggestions for relevant government departments to improve the sports consumption willingness of citizens. In order to expand the development prospect of sports industry from a long-term perspective, it can provide reference for the development of sports consumption.

It Is Me, Chatbot: Working to Address the COVID-19 Outbreak-Related Mental Health Issues in China. User Experience, Satisfaction, and Influencing Factors

The global spread of COVID-19 has caused a huge number of confirmed cases and deaths, which in return leads to a plethora of mental disorders across the world. In order to address citizens’ psychological problems, government agencies in many countries have employed AI-based chatbots to provide mental health services. However, there is a limited understanding of the determinants affecting citizens’ user experience and user satisfaction when mental health services supported by chatbots are provided. Thus, based on the Theory of Consumption Values (TCV), this study proposes an analytical framework to investigate the factors that are important to citizens’ user experience and user satisfaction when they interact with mental health chatbots. Analysis of data collected from 295 chatbot users in Wuhan and Chongqing reveals that personalization, enjoyment, learning, and condition are positively related to user experience and user satisfaction. However, voice interaction fails to devote to citizens’ user experience and user satisfaction. Thus, government agencies and their AI service contractors should enhance the functions and systems of mental health chatbots to ensure citizens’ user experience and user satisfaction. Also, they should more positively promote the use of mental health chatbots during the public health emergency. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Human-Computer Interaction is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Preliminary Evaluation of a New Initiative to Centralize Colorectal Cancer Care During the COVID-19 Epidemic in Shanghai, China: A Retrospective Study (preprint)

Background: A novel colorectal cancer center (CCC) was developed in the Tenth Hospital of Shanghai during the coronavirus disease 2019 (COVID-19) epidemic. We aimed to evaluate the CCC for the centralized management of colorectal cancer (CRC) on three dimensions during this distinctive period. Methods: This retrospective study used data from the Tenth Hospital’s patient databases. The research hypothesis was that the CCC reduces preoperative waiting time (PWT), length of stay (LOS) during hospitalization, and costs of hospitalization, without reducing the quality of surgery. Thus, we analyzed three dimensions: time, cost, and quality. We compared the expected outcomes between March 1–December 31, 2019, and March 1–December 31, 2020. Descriptive and inferential analyses of patient demographic characteristics, time, postoperative outcomes, and inpatient costs were conducted. Findings: A total of 965 hospitalizations for CRC were identified. In the CCC, PWT declined by 26.2 hours (p<0.01). Patients who entered the CCC express group only needed to wait for 24.5 hours before undergoing surgery, with shorter LOS during hospitalization than the normal group (p<0.01). No patients had any symptoms of COVID-19 or high-risk COVID-19 contacts, and the immediate postoperative complication incidence was low. The mean total inpatient cost (TIC) for all patients with CRC was 78309.824 Chinese yuan in 2020, which was slightly lower than this cost in 2019. Interpretation: This study examined the efficiency of the centralized management model for CRC care during the COVID-19 epidemic in terms of time, cost, and quality. Funding Information: This study was sponsored by the Clinical Research Plan of SHDC (No. SHDC2020CR5006-002), the National Natural Science Foundation of China (No.71804128, 71904145), the Special Funds for Fundamental Research Expenses of Central Universities (No. 22120200407) and the Personnel Development Plan of Shanghai Tenth People's Hospital of Tongji University (No. 2021SYPDRC014).Declaration of Interests: None declared.Ethics Approval Statement: This study has been approved by the Ethics Committee of the Shanghai Tenth People's Hospital of Tongji University (SHSY-IEC-4.1/20-272/01).

Self-resetting Molecular Probes for Nucleic Acids Enabled by Fuel Dissipative Systems (preprint)

Amid of COVID-19 pandemic devastating the public health around the world, it become urgent to maintain a sufficiently large supply of nucleic acid tests to screen suspected cases timely. Reusable molecular probes in current testing method could potentially lead to enormous amount of screening capacity, critical for the disease control. Herein, we for the first time report a kind of self-resetting molecular probes for repeatedly detecting SARS-CoV-2 RNA, enabled by orchestrating a biomimetic fuel dissipative system via dynamic DNA nanotechnology. A set of simulation toolkits was utilized for the design and optimization of the self-resetting probe, allowing for highly consistent signal amplitudes across cyclic detections of SARS-CoV-2 RNA. Idiosyncratically, FWHM regulated by dissipative kinetics exhibits a fingerprint signal for high confidential identification of single-nucleotide mutation in the virus sequence. We further exploited our self-resetting probes to examine multiple human-infectious RNA virus including SARS-CoV-2, ZIKV, MERS-CoV, and SARS-CoV to demonstrate its generic nucleic acid detection capability and superior orthogonality. Self-resetting probes were also deployed for detection of 110 clinical nasopharyngeal swabs and correctly classify all the clinical samples from 55 COVID-19 patients and 55 controls. We anticipate that the DNA nanotechnology-enabled self-resetting probe could circumvent the lack of sustainability in the diagnostics of COVID-19 and other infectious diseases, thus helping disease control and building a broader global public health agenda.

The Comparison of Epidemiological Characteristics Between Confirmed and Clinically Diagnosed Cases With COVID-19 in Wuhan, China (preprint)

Background: To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early outbreak. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan.Methods: Demographics, case severity and outcomes of 29886 confirmed cases and 21960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number of SARS-CoV-2 (Rt) was also calculated.Results: The interval between symptom onset and diagnosis of confirmed and clinically diagnosed cases reduced gradually as time went by, and the proportion of severe and critical cases as well as case fatality rates of the two groups all decreased over time. The proportion of severe and critical cases (21.5% vs 14.0%, P<0.0001) and case fatality rates (5.2% vs 1.2%, P<0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in all two groups were older age, male, severe or critical cases. Rt showed a downward trend after the lockdown of Wuhan, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases.Conclusion: Public health responses taken in Wuhan, including clinical diagnosis, have contributed to slow transmission. In cases where testing kits are insufficient, clinical diagnosis is effective, which is helpful to quarantine or treat infected cases as soon as possible, and prevent the epidemic from worsening. To decrease the case fatality rate of COVID-19, it is necessary to strengthen early warning and intervention of severe and critical elderly men.

Workplace Violence Among Frontline Clinicians in Emergency Departments Amidst the COVID-19 Pandemic (preprint)

Background: Frontline clinicians working in the emergency department (ED) were at disportionate risk of workplace violence (WPV). This study investigated the prevalence of WPV and its association on quality of life (QOL) among this population in China during the COVID-19 pandemic.Results: The overall prevalence of WPV was 29.2% (95%CI: 26.5%-31.9%). Multiple logistic regression analysis revealed that having family/friends/colleagues infected with COVID-19 (OR=1.81, P=0.01), current smoking status (OR=3.24, P<0.01) and severity of anxiety symptoms (OR=1.13, P<0.01) were positively associated with WPV.  Working in inpatient ED units (OR=0.45, P<0.01) was negatively associated with WPV. After controlling for covariates, clinicians experiencing WPV had a lower overall QOL compared to those without (F (1, 1103) =14.2, P<0.01).Conclusions: Prevalence of workplace violence was common among ED clinicians in China during the COVID-19 pandemic. Considering the negative impact of WPV on QOL and care quality, timely preventive measures should be undertaken for ED clinicians.

The proportion and effect of corticosteroid therapy for patients with COVID-19 infection: a systematic review and meta-analysis (preprint)

Objectives: COVID-19 remains a global challenge. Corticosteroids are a group of anti-inflammatory and suppressive immune response drugs that are widely used in the treatment of COVID-19, especially when it presents with viral pneumonia. Comprehensive reviews investigating the comparative proportion and efficacy of corticosteroid use are scarce. Therefore, we conducted a systematic review and meta-analysis of clinical trials to evaluate the proportion and efficacy of corticosteroid use for the treatment of COVID-19.Methods: We conducted a comprehensive literature review of PubMed, EMBASE, the Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing Database for relevant trials on glucocorticoid therapy in COVID-19 patients. Outcome measures were the proportion of patients administered corticosteroids, viral clearance and mortality. Effect size was reported as weighted mean differences (WMDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes with associated 95% confidence intervals (CIs).Results: Forty-three trials involving 6603 patients were included. The meta-analysis demonstrated that the proportion of COVID-19 patients who received corticosteroids was significantly lower than that of patients who did not receive corticosteroids. In addition, our meta-analysis demonstrated no significant difference in the proportions of severe and nonsevere patients who were administered corticosteroids. We also performed subgroup analyses stratified by severity, indicating that the proportion of patients administered corticosteroids was significantly higher among intensive care unit (ICU) patients than among non-ICU patients. The results of our meta-analysis indicated that corticosteroid treatment significantly delayed the viral clearance time. Finally, our meta-analysis demonstrated no significant difference between the use of corticosteroids for COVID-19 patients who died and those who survived. This result indicated that mortality was not correlated with corticosteroid therapy.Conclusion: The proportion of COVID-19 patients who received corticosteroids was significantly lower than that of patients who did not receive corticosteroids. Corticosteroid use in subjects with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections delayed virus clearance and did not convincingly improve survival;therefore, corticosteroids should be used with caution in the treatment of COVID-19.

Application of Telemedicine During the Coronavirus Disease Epidemics: A Rapid Review and Meta-Analysis (preprint)

Background: As COVID-19 has become a global pandemic, early prevention and control of the epidemic is extremely important. Telemedicine, which includes medical advice given over telephone, Internet, mobile phone applications or other similar ways, may be an efficient way to reduce transmission and pressure on medical institutions. Methods: We searched MEDLINE, Web of science, Embase, Cochrane, CBM, CNKI and Wanfang databases for literature on the use of telemedicine for COVID-19, SARS and MERS. from their inception to March 31st, 2020. We included studies about the content of the consultation (such as symptoms, therapy and prevention, policy, public service), screening of suspected cases, the provision of advice given to those people who may have symptoms or contact history. We conducted meta-analyses on the main outcomes of the studies. Results: A total of 2041 articles were identified after removing duplicates. After reading the full texts, we finally included nine studies. People were most concerned about symptoms (64.2%), epidemic situation and public problems (14.5%), and psychological problems (10.3%) during COVID-19 epidemic. During the SARS epidemic, the proportions of people asking for consultation for symptoms, prevention and therapy, and psychological problems were 35.0%, 22.0%, and 23.0%, respectively. Two studies demonstrated that telemedicine can be used to screen the suspected patients and give advice. One study emphasized the limited possibilities to follow up people calling hotlines and difficulties in identifying all suspect cases. Conclusions: Telemedicine services should focus on the issues that the public is most concerned about, such as then symptoms, prevention and treatment of the disease, and provide reasonable advice to patients with symptoms or people with epidemic history. KeywordsCOVID-19; SARS; MERS; telemedicine; rapid review

Nosocomial Infections Among Patients with COVID-19, SARS and MERS: A Rapid Review and Meta-Analysis (preprint)

Background: COVID-19, a disease caused by SARS-CoV-2 coronavirus, has now spread to most countries and regions of the world. As patients potentially infected by SARS-CoV-2 need to visit hospitals, the incidence of nosocomial infection can be expected to be high. Therefore, a comprehensive and objective understanding of nosocomial infection is needed to guide the prevention and control of the epidemic. Methods: We searched major international and Chinese databases Medicine, Web of science, Embase, Cochrane, CBM(China Biology Medicine disc), CNKI (China National Knowledge Infrastructure) and Wanfang database)) for case series or case reports on nosocomial infections of COVID-19, SARS(Severe Acute Respiratory Syndromes) and MERS(Middle East Respiratory Syndrome) from their inception to March 31st, 2020. We conducted a meta-analysis of the proportion of nosocomial infection patients in the diagnosed patients, occupational distribution of nosocomial infection medical staff and other indicators. Results: We included 40 studies. Among the confirmed patients, the proportions of nosocomial infections were 44.0%, 36.0% and 56.0% for COVID-19, SARS and MERS, respectively. Of the confirmed patients, the medical staff and other hospital-acquired infections accounted for 33.0% and 2.0% of COVID-19 cases, 37.0% and 24.0% of SARS cases, and 19.0% and 36.0% of MERS cases, respectively. Nurses and doctors were the most affected among the infected medical staff. The mean numbers of secondary cases caused by one index patient were 29.3 and 6.3 for SARS and MERS, respectively. Conclusions: The proportion of nosocomial infection in patients with COVID-19 was 44%. Patients attending hospitals should take personal protection. Medical staff should be awareness of the disease to protect themselves and the patients. Keywords: COVID-19; meta-analysis; nosocomial infection; rapid review.

The comparative superiority of IgM-IgG antibody test to real-time reverse transcriptase PCR detection for SARS-CoV-2 infection diagnosis (preprint)

Background: As the increasing number of Corona Virus Disease 2019 (COVID-19) patients caused by the severe acute respiratory coronavirus 2 (SARS-CoV-2), which caused an outbreak initiated from Wuhan, China in December, 2019, the clinical features and treatment of COVID-19 patients have been understood. However, it is urgent to need the rapid and accurate detection for SARS-CoV-2 infection diagnosis. We aimed to evaluate the antibodies-based and nucleic acid-based tests (NAT) for SARS-CoV-2-infected patients. Method: We retrospectively and observationally studied 133 patients diagnosed with SARS-CoV-2 and admitted in Renmin Hospital of Wuhan University, China, from Feb 17 to Mar 1, 2020. Demographic data, symptoms, clinical examination, laboratory tests, and clinical outcomes were collected. Data were compared between IgM-IgG antibody test and real-time RT-PCR detection for COVID-19 patients. Results: Of 133 patients with SARS-CoV-2 infection, there were 44 moderate cases, 52 severe cases, and 37 critical cases with no significant difference of gender and age among three subgroups. Overall, the positive ratio in IgM antibody test was higher than in RT-PCR detection. In RT-PCR detection, the positive ratio was 65.91%, 71.15%, and 67.57% in moderate, severe, and critical cases, respectively. Whereas, the positive ratio of IgM/IgG antibody detection in patients was 79.55%/93.18%, 82.69%/100%, and 72.97%/97.30% in moderate, severe, and critical cases, respectively. Moreover, the concentrations of antibodies were also measured in three subgroups. Conclusion: The IgM-IgG antibodies-based test exhibited a comparative superiority to the NAT for COVID-19 diagnosis, which provides an effective complement to the false negative results from NAT for SARS-CoV-2 infection diagnosis.

Clinical Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients out of Wuhan from China (preprint)

Background: A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. Objective: To examine the clinical characteristics of COVID-19in infected patients out of Wuhan, from China. Patients and Methods: Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27andFebruary 8, 2020, in Baoji city, Shanxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected; cases were divided into two groups according to the severity of infection (mild or severe). Results: Nine (9/13) COVID-19patientsexhibitedmild disease severity, and defined as second-generation, human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P>0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms; however, there was no statistical difference between mild and severe cases in this regard (all P>0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19infection, with statistically significant differences between those with severe disease and mild infection (all P<0.05).Twelve of 13COVID-19patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P<0.05).Conclusion: Most cases of COVID-19infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19varied.Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19diseaselackedtypicalcharacteristics such as fever and changes in CT imaging features.